[Unhealthy eating, physical inactivity and childhood obesity in Colombia: an urgent call for the state and civil society to undertake effective action]

Insights from a cross-sectional binational study comparing obesity among nonimmigrant Colombians in their home country and Colombian immigrants in the U.S

BACKGROUND

Latinos in the United States (U.S.) represent a heterogeneous minority population disproportionally impacted by obesity. Colombians in the U.S. are routinely combined with other South Americans in most obesity studies. Moreover, most studies among Latino immigrants in the U.S. solely focus on factors in the destination context, which largely ignores the prevalence of obesity and contextual factors in their country of origin, and warrant transnational investigations.

METHODS

Using 2013-17 data from the New York City Community Health Survey (NYC CHS, U.S.) and the National Survey of the Nutritional Situation (ENSIN, Colombia), Colombians that immigrated to the U.S. and are living in NYC (n = 503) were compared to nonimmigrant Colombians living in their home country (n = 98,829). Prevalence ratios (PR) for obesity (BMI ≥ 30 kg/m2) by place of residence were estimated using multivariable logistic regression adjusting for socio-demographic characteristics and daily consumption of sugar-sweetened beverages.

RESULTS

The prevalence of obesity was 49% greater for immigrant Colombians living in NYC when compared to nonimmigrant Colombians living in in their home country (PR = 1.49; 95% CI 1.08, 2.07). Colombian immigrant men in NYC were 72% more likely to have obesity compared to nonimmigrant men living in their home country (PR = 1.72; 95% CI 1.03, 2.87). No significant differences were found in the adjusted models among women.

CONCLUSIONS

Colombian immigrants in NYC exhibit a higher prevalence of obesity compared to their nonimmigrant counterparts back home and sex strengthens this relationship. More obesity research is needed to understand the immigration experience of Colombians in the U.S. and the underlying mechanisms for sex difference. Public health action focused on women in Colombia and both Colombian men and women immigrants in the U.S. is warranted to avert the long-term consequences of obesity.

Investigaciones realizadas en Colombia relacionadas con actividad física y obesidad 2010-2020

Introducción: La obesidad es un problema de salud pública mundial. La actividad física es una herramienta importante de promoción y prevención de este problema. Se desconoce las investigaciones realizadas en Colombia al respecto, lo cual es necesario para implementar políticas públicas eficientes. Objetivo: analizar las investigaciones colombianas encontradas en bases de datos científicas sobre la actividad física y obesidad. Metodología: revisión sistemática de artículos de investigación realizados en Colombia del año 2010 al 2020, en las bases de datos PubMed y SciELO.  Resultados: de 87 artículos encontrados, 23 cumplieron los criterios de inclusión. El 91,3 % publicados en revistas indexadas internacionalmente. 69,5% estudios observacionales, 17,4% ensayos clínicos y 8,7% revisiones sistemáticas. Conclusiones: poca producción en Colombia. La mayoría en revistas indexadas, tuvieron diseño observacional y encontraron asociación entre poca actividad física con sobrepeso/obesidad. Alta prevalencia de sobrepeso/obesidad. Pocos autores fueron profesionales en el área del deporte y el entrenamiento. Introduction: Obesity is a global public health problem. Physical activity and exercise are important tools for promoting and preventing. The research carried out in Colombia in this regard is unknown, which is necessary to implement efficient public policies. Objective: to analyze Colombian research found in scientific databases on physical activity or exercise in overweight and obesity. Methodology: literary review of research articles carried out in Colombia from 2010 to 2020, in the PubMed and SciELO databases. Results: Of 87 articles found, 23 met the inclusion criteria. 91.3% published in internationally indexed journals. 69.5% observational studies, 17.4% clinical trials and 8.7% systematic reviews. Conclusions: little production in Colombia. Most of the indexed journals had an observational design and found an association between little physical activity and overweight/obesity. High prevalence of overweight/obesity. Few authors were professionals in the area of training.

Overweight and obesity: Family factors, diet, and physical activity in school children from middle to high socioeconomic level in Cali, Colombia

Introduction: Colombia is a country with overweight and obesity problems, which, in many cases, are due to bad eating habits. Objective: To describe the prevalence of overweight and obesity, as well as family, dietary, and physical activity factors in a group of schoolchildren between 6 and 9 years old from socioeconomic level 4 in Cali, Colombia. Materials and methods: This was a descriptive cross-sectional study of 150 children from an educational institution in Cali. To collect the sociodemographic data we used a previously validated instrument; the anthropometric measurements were analyzed to diagnose the nutritional status in the World Health Organization (WHO) Anthro Plus program program. A total of 62 children were identified as overweight and obese. Results: Regarding the nutritional diagnosis, 42 (28%) children were overweight and 20 (13%) were obese; 78% belonged to socioeconomic levels 4 and 5. As for the family characteristics, 47% had only one sibling and 25% were only children; 76% of the mothers and 70% of the fathers were professionals; 95% of the children did not do significant physical activity. Conclusions: Our analysis showed an association between the nutritional status and the number of siblings; schoolchildren with a higher prevalence of overweight or obesity tended to be only children or have just one sibling. We also found associations between mothers’ age, especially at ages 41-50 years, parents’ schooling and whether they had an occupation or job outside the home, as well as belonging to socioeconomic levels 4 and 5.

Derecho al consumo informado: el caso de las bebidas azucaradas en Colombia

Introducción: se presenta un análisis sobre el derecho al consumo informado en el caso de las bebidas azucaradas, a través del recorrido administrativo y judicial en Colombia. Metodología: se hace desde una perspectiva jurídica, bioética y médica, señalando cómo la protección judicial de este derecho se da gracias al activísimo social y judicial que se enfrenta con el lobby de la industria, cuyos intereses también inciden, no en el ámbito del acceso a la justicia, pero si en el del diseño de políticas públicas en salud para reducir el consumo de bebidas azucaradas.  Conclusiones: de la revisión de la literatura se encontró que ciertas enfermedades no transmisibles se asocian con el consumo de estos productos, por lo cual en diferentes regiones del mundo se han replanteado medidas para mitigar su impacto, mientras en Colombia el escenario desde las políticas públicas no ha sido favorable.

Time use in daily activities by Chilean overweight and obese adolescents

Introduction: Obesity is a global serious public health issue. According to the World Health Organization, insufficient physical activity and increased sedentary behaviors are the leading causes of this condition.Objective: To compare the time that overweight/obese and normal-weight adolescents spend in daily activities according to sex and the type of school they attend.Materials and methods: Quantitative and analytical research. 106 Chilean teenagers were assessed to determine their nutrition diagnosis based on their weight, height, pubertal development (Tanner stages) and body mass index. A written survey was used to collect data on how they spend their time in different activities during a typical day on weekdays. Statistical analysis was performed using the Mann-Whitney U test, in which two non-parametric samples are compared.Results: Statistically significant differences regarding the distribution of the time that adolescents devote to engaging in social participation and leisure time activities were observed: overweight/obese teenagers spend less time in these activities.Conclusion: the way that adolescents use their time could be considered as a risk factor for obesity that requires a deeper analysis. Overweight and obese adolescents have a low participation rate in social participation and leisure activities. Undoubtedly, how time is spent is increasingly regarded as a well-being indicator; therefore, further research should focus on the effectiveness of interventions based on the modification of daily routines.

Urban environment interventions linked to the promotion of physical activity: a mixed methods study applied to the urban context of Latin America

This study summarizes the evidence from quantitative systematic reviews that assessed the association between urban environment attributes and physical activity. It also documents sociopolitical barriers and facilitators involved in urban interventions linked with active living in the ten most populated urban settings of Latin America. The synthesis of evidence indicates that several attributes of urban environments are associated with physical activity, including land-use mix and cycling infrastructure. The documentary analysis indicated that despite the benefits and opportunities provided by the programs and existing infrastructure in the examined cities, an overall concern is the rising inequality in the coverage and distribution of the initiatives in the region. If these programs and initiatives are to achieve a real population level effect that helps to reduce health disparities, they need to examine their social and spatial distribution within the cities so they can reach underserved populations and develop to their full potential.